BOISE DERMAESTHETICS LLC NPI 1639117153

NPI Information

NPI: 1639117153
Provider Name: BOISE DERMAESTHETICS, LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Former Legal Business Name: MCCONNEHEY FAMILY MEDICINE
Address: 6126 W EMERALD ST
BOISE, ID
ZIP 83704
Phone: (208) 323-6525

Map and Directions

Get Directions

NPI Details

BOISE DERMAESTHETICS, LLC is a family medicine in Boise, ID. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. BOISE DERMAESTHETICS, LLC NPI is 1639117153. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Mcconnehey Family Medicine.

The provider's business location address is:

6126 W EMERALD ST
BOISE, ID
ZIP 83704-857
Phone: (208) 323-6525

The provider's authorized official is Cheryl D Lundy .
The authorized official title is Billing Manger and has the following contact phone number (208) 452-6794.

The enumeration date for this NPI number is 6/4/2006 and was last updated on 9/12/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1504891	MEDICARE ID-TYPE UNSPECIFIED

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI

Next NPI